58120 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)

Name of the Procedure:

Dilation and Curettage (D&C)

Summary

Dilation and Curettage, commonly referred to as D&C, is a procedure where the cervix is dilated (widened) to allow a special instrument to be inserted into the uterus. This instrument is used to scrape or suction away the lining of the uterus for diagnostic or therapeutic purposes.

Purpose

D&C addresses abnormal uterine bleeding, uterine polyps, fibroids, and missed or incomplete miscarriages. The goals of the procedure include diagnosing uterine conditions, stopping abnormal bleeding, and clearing the uterine lining.

Indications

• Heavy or prolonged menstrual periods
• Irregular or excessive menstrual bleeding
• Postmenopausal bleeding
• Uterine polyps or fibroids
• Incomplete miscarriage or retained tissue

Preparation

• Fasting for 6-8 hours before the procedure
• Stopping certain medications as advised by the doctor
• Undergoing pre-procedure blood tests or imaging studies
• Arranging for a ride home post-procedure due to sedation

Procedure Description

1. Patient is positioned and given anesthesia (local, regional, or general).
2. The cervix is gently dilated using special instruments.
3. A curette (a spoon-shaped instrument) or suction device is inserted to remove tissue from the uterine lining.
4. The tissue is collected for examination if needed.

Duration

The procedure typically takes 15-30 minutes.

Setting

D&C is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Gynecologist or obstetrician-gynecologist (OB-GYN)
• Anesthesiologist (if general or regional anesthesia is used)
• Nurses and surgical assistants

Risks and Complications

• Common risks: Bleeding, cramping, infection
• Rare risks: Uterine perforation, adhesions (Asherman syndrome)
• Management includes antibiotics for infection and monitoring for complications

Benefits

• Accurate diagnosis of uterine conditions
• Relief from abnormal bleeding or discomfort
• Improvement can be noticed within days to weeks

Recovery

• Rest and avoid strenuous activity for a few days
• Expect light bleeding or spotting for 7-10 days
• Pain management with over-the-counter pain relievers
• Follow-up appointments to monitor recovery

Alternatives

• Medication to manage bleeding or other symptoms
• Hysteroscopy for direct visualization and treatment
• Endometrial ablation for permanent reduction of uterine lining
• Each alternative has its benefits and limitations; D&C is often quicker and effective for immediate issues.

Patient Experience

Patients might feel mild to moderate cramping similar to menstrual cramps post-procedure. Sedation or anesthesia ensures comfort during the procedure. Pain management and comfort measures are provided to ease recovery.